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Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing.
Clin Microbiol Infect. 2015 Nov; 21(11):1001-7.CM

Abstract

An outbreak of carbapenem-resistant Klebsiella pneumoniae strains emerged at a hospital, and was tracked in order to understand the spread of these infectious pathogens. A total of 66 K. pneumoniae strains were collected from sterile samples in 2012. The MICs of 20 antimicrobial agents were determined for all strains. Molecular typing was performed with pulsed-field gel electrophoresis (PFGE). Twelve blaKPC-producing K. pneumoniae strains isolated from ten patients were selected for whole genome sequencing. Phylogenetic reconstruction of these 12 strains was performed by the use of single-nucleotide polymorphism (SNP) row sequences of each draft genome sequence. Plasmids from the 12 strains were separated by S1 digestion and PFGE. The 12 K. pneumoniae strains isolated from the ten patients were deemed to be representative of the hospital outbreak, owing to their similar PFGE patterns. These 12 blaKPC-producing strains conferred multidrug resistance, which contrasted with the remaining 54, more susceptible, strains in the hospital. Differences in SNPs between each draft genome of the blaKPC-producing strains partitioned the 12 outbreak strains into three separate clades. The patients with each clade shared close hospital units. All 12 strains harboured at least one multidrug resistance plasmid. Strains showing high-level resistance may facilitate nosocomial dissemination and result in an infectious pathogen outbreak. Although the 12 blaKPC-producing K. pneumoniae strains possessed similar PFGE patterns, SNP variations throughout the genome allowed the strains to be divided into three clades. These results suggest that three independent transmission events led to hospital-wide dissemination of the outbreak strains.

Authors+Show Affiliations

Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Hangzhou, Zhejiang, China.State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Hangzhou, Zhejiang, China.Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Hangzhou, Zhejiang, China.Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Hangzhou, Zhejiang, China.Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Hangzhou, Zhejiang, China; Translational Medicine Centre, Zhejiang University, Hangzhou, Zhejiang, China.Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Hangzhou, Zhejiang, China; State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Hangzhou, Zhejiang, China. Electronic address: yvys119@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26166545

Citation

Jiang, Y, et al. "Tracking a Hospital Outbreak of KPC-producing ST11 Klebsiella Pneumoniae With Whole Genome Sequencing." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 21, no. 11, 2015, pp. 1001-7.
Jiang Y, Wei Z, Wang Y, et al. Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing. Clin Microbiol Infect. 2015;21(11):1001-7.
Jiang, Y., Wei, Z., Wang, Y., Hua, X., Feng, Y., & Yu, Y. (2015). Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 21(11), 1001-7. https://doi.org/10.1016/j.cmi.2015.07.001
Jiang Y, et al. Tracking a Hospital Outbreak of KPC-producing ST11 Klebsiella Pneumoniae With Whole Genome Sequencing. Clin Microbiol Infect. 2015;21(11):1001-7. PubMed PMID: 26166545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tracking a hospital outbreak of KPC-producing ST11 Klebsiella pneumoniae with whole genome sequencing. AU - Jiang,Y, AU - Wei,Z, AU - Wang,Y, AU - Hua,X, AU - Feng,Y, AU - Yu,Y, Y1 - 2015/07/10/ PY - 2015/04/22/received PY - 2015/07/02/revised PY - 2015/07/02/accepted PY - 2015/7/14/entrez PY - 2015/7/15/pubmed PY - 2016/8/3/medline KW - Carbapenem resistance KW - SNP KW - outbreak KW - plasmid KW - whole genome sequencing SP - 1001 EP - 7 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 21 IS - 11 N2 - An outbreak of carbapenem-resistant Klebsiella pneumoniae strains emerged at a hospital, and was tracked in order to understand the spread of these infectious pathogens. A total of 66 K. pneumoniae strains were collected from sterile samples in 2012. The MICs of 20 antimicrobial agents were determined for all strains. Molecular typing was performed with pulsed-field gel electrophoresis (PFGE). Twelve blaKPC-producing K. pneumoniae strains isolated from ten patients were selected for whole genome sequencing. Phylogenetic reconstruction of these 12 strains was performed by the use of single-nucleotide polymorphism (SNP) row sequences of each draft genome sequence. Plasmids from the 12 strains were separated by S1 digestion and PFGE. The 12 K. pneumoniae strains isolated from the ten patients were deemed to be representative of the hospital outbreak, owing to their similar PFGE patterns. These 12 blaKPC-producing strains conferred multidrug resistance, which contrasted with the remaining 54, more susceptible, strains in the hospital. Differences in SNPs between each draft genome of the blaKPC-producing strains partitioned the 12 outbreak strains into three separate clades. The patients with each clade shared close hospital units. All 12 strains harboured at least one multidrug resistance plasmid. Strains showing high-level resistance may facilitate nosocomial dissemination and result in an infectious pathogen outbreak. Although the 12 blaKPC-producing K. pneumoniae strains possessed similar PFGE patterns, SNP variations throughout the genome allowed the strains to be divided into three clades. These results suggest that three independent transmission events led to hospital-wide dissemination of the outbreak strains. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/26166545/Tracking_a_hospital_outbreak_of_KPC_producing_ST11_Klebsiella_pneumoniae_with_whole_genome_sequencing_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(15)00691-6 DB - PRIME DP - Unbound Medicine ER -